HomeMy WebLinkAboutDrain Layers Permit 55 Rockledge Drive /. .. .-�. ..:. _.. .-va.v.. .+i ....ys......�_—^c.-,. ... �q't�.4ItR•�-T�'�. '1
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TOWN OF SOUTH WI N DSOR
DEPARTMkNT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut }
List.No.: _
DRAIN LAYER"S PERMIT �� 3124
19
Pursuant to written applicatior,2permis is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at (� 3 *,55
on the
side, be w n
at premises owned by G
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other ,
,for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ),-INDUSTRIAL WASTES OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on-, 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof._ Applicant has received Town Permit No. and/or C H D.Permit No.
--- fQr--street excavation_....
SPECIAL CONDITIONS -
Signed
Connection Charge Paid Licensed Drain Layer
Issued by
f" t/ Tax Collector
�C Permit Fee: Paid $
INSPECTION: Check Number: -
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR